Supplies Order Form

Note: Supplies with a cost attached must be paid for before the order can be sent. Please mail a check to the Business Manager for the cost of your order. Include on the check your cast name and the date of the order. Prices effective through January 1, 2013.

This order form can be printed and mailed to:

Dr. Bret Jones
National Business Manager, Alpha Psi Omega/Delta Psi Omega
Wichita State University
1845 Fairmount St.
Box 153
Wichita, KS 67260

or can be submitted (via e-mail) by pressing the submit button at the end of this form.

	Item	Cost
	Society? Alpha Psi Omega Delta Psi Omega
1.	Pledge Cards	No Cost
2.	APO Replacement Membership Cards	$10.00 each
3.	DPO Replacement Membership Cards	$5.00 each
4.	Replacement Membership Forms	No Cost
5.	Pins	$15.00 each
6.	APO Official Song	$2.50 each
7.	Constitution and Ceremonies	$15.00 each
8.	Replacement Membership Certificates	$10.00 each
9.	Cast Charter	$35.00 each
10.	Cast Scroll	$25.00 each
11.	Banner	$50.00 each
12.	Copy of the National Office File On:	$15.00
13.	Back Issue(s) of PLAYBILL (as available) from	$5.00
14.	Other (please specify):

Person Making Order:

Name:

E-mail Address:

Cast:

Address:

Human Check:

Type the text you see
to the right into this box:

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Supplies Order Form